Academic literature on the topic 'Healthcare Systems Design'

Thesis: S.M. in Engineering and Management, Massachusetts Institute of Technology, Engineering Systems Division, 2015.<br>Cataloged from PDF version of thesis.<br>Includes bibliographical references (pages 85-90).<br>Since the HITECH Act of 2009, adoption of Electronic Health Record (EHR) systems in US healthcare organizations has increased significantly. Along with the rapid increase in usage of EHR, cybercrimes are on the rise as well. Two recent cybercrime cases from early 2015, the Anthem and Premera breaches, are examples of the alarming increase of cybercrimes in this domain. Although modem Information Technology (IT) systems have evolved to become very complex and dynamic, cybersecurity strategies have remained static. Cyber attackers are now adopting more adaptive, sophisticated tactics, yet the cybersecurity counter tactics have proven to be inadequate and ineffective. The objective of this thesis is to analyze the recent Anthem security breach to assess the vulnerabilities of Anthem's data systems using current cybersecurity frameworks and guidelines and the Systems-Theoretic Accident Model and Process (STAMP) method. The STAMP analysis revealed Anthem's cybersecurity strategy needs to be reassessed and redesigned from a systems perspective using a holistic approach. Unless our society and government understand cybersecurity from a sociotechnical perspective, we will never be equipped to protect valuable information and will always lose this battle.<br>by Kristie Chung.<br>S.M. in Engineering and Management

Thesis (S.M. in Engineering and Management)--Massachusetts Institute of Technology, Engineering Systems Division, System Design and Management Program, 2012.<br>Cataloged from PDF version of thesis.<br>Includes bibliographical references (p. 60-63).<br>This thesis is a study on the adoption of cloud computing in healthcare information technology industry. It provides a guideline for people who are trying to bring cloud computing into healthcare information systems through the use of a framework of tools and processes to overcome both technical and business challenges.<br>by Haiying Ren.<br>S.M.in Engineering and Management

Healthcare information systems (HISs), as a class of systems, are not currently addressed in the MIS literature. This is in spite of a sharp increase in use over the past few years, and the uniquely qualified role that MIS has in the development of, impact and general understanding of HISs. In this project the design science paradigm frames the development of a set of design principles derived from the synthesis of the design literature, ethics literature, and professional guidelines, from both the medical and computing professions. The resulting principles are offered to address the design of healthcare information systems. Action research, a widely accepted methodology for testing design principles derived from the design science paradigm, is employed to test the HIS principles and to implement change in a healthcare organization through the use of an HIS. The action research project was a collaborative effort between a Central Florida hospice and the researcher, the result of which was an advanced directives decision support system. The system was design to meet a number of organizational goals that ranged from tracking compliance with federal regulations to increasing the autonomy of the patients that used the system. The result is a set of tested design principles and lessons learned from both anticipated and unanticipated consequences of the action research project.<br>Ph.D.<br>Department of Management Information Systems<br>Business Administration<br>Business Administration: Ph.D.

Thesis: S.M. in Engineering and Management, Massachusetts Institute of Technology, Engineering Systems Division, System Design and Management Program, February 2015.<br>Cataloged from PDF version of thesis.<br>Includes bibliographical references (page 77).<br>Usage in information technology (IT) have improved efficiency and quality in many industries. Healthcare has not been one of them. Although some administrative IT systems, such as those for billing, scheduling, and inventory management, are already in place in the healthcare industry, little adoption of clinical IT, such as Electronic Medical Record Systems (EMR-S) and Clinical Decision Support tools, has occurred. India's healthcare information technology market is slow with technology adoption but there is little traction shown in last couple of years. This growth is expected to hit US $1.45 billion in 2018, more than three times the US $381.3 million reached in 2012. The increase in adoption of electronic health records, mHealth, telemedicine, and Web-based services has made electronic patient data expand, necessitating the implementation of robust IT systems in Indian healthcare institutions. Information technology (IT) has the potential to improve the quality, safety, and efficiency of health care. Diffusion of IT in health care is generally low (varying, however, with the application and setting) but surveys indicate that providers plan to increase their investments. Drivers of investment in IT include the promise of quality and efficiency gains. Barriers include the cost and complexity of IT implementation, which often necessitates significant work process and cultural changes. Given IT's potential, both the private and public sectors have engaged in numerous efforts to promote its use within and across health care settings. Delivering quality health care requires providers and patients to integrate complex information from many different sources. Thus, increasing the ability of physicians, nurses, clinical technicians, and others to readily access and use the right information about their patients should improve care. The purpose of this thesis is to assess the current state of healthcare in India and specifically look into the emerging technology trends in healthcare IT. During analysis secondary data has been used. Various articles and research papers published in national and international journals are used. India is hub of IT and its use is increasing in health sector.<br>by Sanjay Kumar Gautam.<br>S.M. in Engineering and Management

Thesis: S.M. in Engineering and Management, Massachusetts Institute of Technology, Engineering Systems Division, 2015.<br>Cataloged from PDF version of thesis.<br>Includes bibliographical references (pages [66]-[67]).<br>Affordability of healthcare is a growing concern across the world. For India, with a population of over 1.2 billion people and one third of world's poorest, to provide affordable and sustainable healthcare to all its citizens becomes even more challenging. The country faces the triple burden of controlling communicable diseases, managing non communicable diseases, and limiting the deaths from injury and mental health. The public healthcare system is underfunded and underutilized while the private facilities are unregulated and unaccountable for quality and cost of care. The high reliance of the population on the private facilities, low insurance coverage, and high emphasis on curative care than the preventive care is further making the cost prohibitive for the general population. There is a lot to be desired in the areas of Pharmaceuticals, Medical Devices, and Research and Development for a holistic development of healthcare system in India. This thesis attempts to model the current healthcare system and how different entities of the system interact to influence the affordability. The simulation of the model projects the affordability in the next 50 years. The study also checks the impact of three different policies on the affordability of care.<br>by Anjali Chaudhary.<br>S.M. in Engineering and Management

Thesis (S.M. in Management and Engineering)--Massachusetts Institute of Technology, Engineering Systems Division, System Design and Management Program, 2012.<br>Cataloged from PDF version of thesis.<br>Includes bibliographical references (p. 63-64).<br>In the current shift in the US healthcare system, lower cost, higher quality of care, access and safety are the main drivers that are effecting changes. Patient compliance with medication and technology enabled wellness and engagement programs play an important role in ensuring the cost and quality of care is reduced. In a recent study, the overall cost of poor medication adherence, measured in otherwise avoidable medical spending, is close to $310 billion annually, representing approximately 14% of total healthcare expenditures. There have been several studies analyzing the reasons for and impact of non-adherence and solutions to achieve increasing compliance. With the recent wave in healthcare technology, the scope of prescription medication adherence needs to be expanded to include patient engagement and their awareness towards lifestyle changes and managing their own health. This thesis engages in an analysis of these compliance issues and in understanding the relationships among the various stakeholders involved. It also analyses the several technology platforms and solutions from mobile health to "gamification" and social networks from a business, user and regulatory standpoint. It looks into how these newer health technologies helps the individual in adhering and realizing novel insights into their own patterns related to medication, lifestyle and general health. Further, working with a health technology startup catering to the behavioral care market, a real world application of a health technology product that utilizes technology based patient assessment, decision support and patient communication, will be evaluated to explore how it will help in delivering value to several stakeholders.<br>by Chetan R. Jog.<br>S.M.in Management and Engineering

Increasing number of ageing population and people who need continuous health monitoring and rising the costs of health care have triggered the concept of the novel wireless technology-driven human body monitoring. Human body monitoring can be performed using a network of small and intelligent wireless medical sensors which may be attached to the body surface or implanted into the tissues. It enables carers to predict, diagnose, and react to adverse events earlier than ever. The concept of Wireless Body Area Network (WBAN) was introduced to fully exploit the benefits of wireless technologies in telemedicine and m-health. The main focus of this research is the design and performance evaluation of strategies and architectures that would allow seamless and efficient interconnection of patient’s body area network and the stationary (e.g., hospital room or ward) wireless networks. I first introduce the architecture of a healthcare system which bridges WBANs and Wireless Local Area Networks (WLANs). I adopt IEEE 802.15.6 standard for the patient’s body network because it is specifically designed for WBANs. Since IEEE 802.15.6 has strict Quality of Service (QoS) and priorities to transfer the medical data to the medical server a QoS-enabled WLAN for the next hop is needed to preserve the end-to-end QoS. IEEE 802.11e standard is selected for the WLAN in the hospital room or ward because it provides prioritization for the stations in the network. I investigate in detail the requirements posed by different healthcare parameters and to analyze the performance of various alternative interconnection strategies, using the rigorous mathematical apparatus of Queuing Theory and Probabilistic Analysis; these results are independently validated through discrete event simulation models. This thesis has three main parts; performance evaluation and MAC parameters settings of IEEE 802.11e Enhanced Distributed Channel Access (EDCA), performance evaluation and tuning the MAC parameters of IEEE 802.15.6, and designing a seamless and efficient interconnection strategy which bridges IEEE 802.11e EDCA and IEEE 802.15.6 standards for a healthcare system.

Healthcare is in urgent need of an effective way to manage the complexity it of its systems and to prepare quickly for immense changes in the economics of healthcare delivery and reimbursement. Centers for Medicare & Medicaid Services (CMS) releases policies affecting inpatient and long-term care hospitals policies that directly affect reimbursement and payment rates. One of these policy changes, a quality-reporting program called Hospital Inpatient Quality Reporting (IQR), will effect approximately 3,400 acute-care and 440 long-term care hospitals. IQR sets guidelines and measures that will contain financial incentives and penalties based on the quality of care provided. CMS, the largest healthcare payer, is aggressively promoting high quality of care by linking payment incentives to outcomes. With CMS assessing each hospital's performance by comparing its Quality Achievements and Quality Improvement scores, there is a growing need and demand to understand these quality measures under the context of patient care, data management and system integration. This focus on patient-centered quality care is difficult for healthcare systems due to the lack of a systemic view of the patient and patient care. This research uniquely addresses the hospital's need to meet these challenges by presenting a healthcare specific framework and methodology for translating data on quality metrics into actionable processes and feedback to produce the desired quality outcome. The solution is based on a patient-care level process ontology, rather than the technology itself, and creates a bridge that applies systems engineering principles to permit observation and control of the system. This is a transformative framework conceived to meet the needs of the rapidly changing healthcare landscape. Without this framework, healthcare is dealing with outcomes that are six to seven months old, meaning patients may not have been cared for effectively. In this research a framework and methodology called the Healthcare Ontology Based Systems Engineering Model (HOB-SEM) is developed to allow for observability and controllability of compartmental healthcare systems. HOB-SEM applies systems and controls engineering principles to healthcare using ontology as the method and the data lifecycle as the framework. The ontology view of patient-level system interaction and the framework to deliver data management and quality lifecycles enables the development of an agile systemic healthcare view for observability and controllability